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Related Experiment Videos

Cerebral actinomycosis before adolescence.

E Olah1, C Berger, E Boltshauser

  • 1Division of Infectious Diseases, University Children's Hospital of Zurich, Zurich, Switzerland.

Neuropediatrics
|August 26, 2004
PubMed
Summary

This case report details a rare cerebral abscess caused by Actinomyces israelii in a child with congenital heart disease. Despite delayed diagnosis and treatment, the patient fully recovered from neurological deficits.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Cerebral actinomycosis is a rare bacterial infection, often presenting with non-specific symptoms.
  • Congenital heart disease with pulmonary arteriovenous shunts can predispose individuals to paradoxical embolism and brain abscess formation.
  • Actinomyces israelii, an anaerobic bacterium, is an uncommon cause of central nervous system infections.

Observation:

  • A 10-year-old immunocompetent boy with complex congenital heart disease presented with focal seizures, followed by acute hemiparesis.
  • Delayed diagnosis due to parental reluctance for neuroimaging.
  • A cerebral abscess caused by Actinomyces israelii was diagnosed.

Findings:

  • Neurosurgical excision of the abscess and a 4-week course of ceftriaxone were administered.

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  • Despite the delay, complete recovery from hemiparesis was achieved.
  • This represents the first reported case of cerebral actinomycosis in a pre-adolescent child.

    • Implications:

    • Highlights the importance of considering rare infections like actinomycosis in pediatric neurological presentations, especially in those with underlying conditions.
    • Emphasizes the need for timely neuroimaging in suspected cases, even with parental hesitancy.
    • Demonstrates that favorable outcomes are possible with aggressive management, including surgery and antibiotics, even after delayed diagnosis.